Abstract
Abdominal wall reconstruction has undergone substantial evolution over the last few
decades. The optimal method of repair should be tailored to each patient's unique
condition; however, a general approach that integrates four major factors can be applied
as a conceptual framework to most clinical scenarios. Major factors to be considered
include selection of mesh material, mesh inset position and technique, selective component
separation, and management of soft tissue. These topics are inextricably intertwined
in the sense that each can have specific implications, and in some cases, a determinative
impact on the other decisions. When the relationship among these four factors is appreciated
and applied to patient management, the reconstructive surgeon can achieve consistent
outcomes that reflect skill, experience, and understanding.
Keywords
abdominal wall reconstruction - ventral hernia repair - biologic mesh - synthetic
mesh - component separation
